Mezial temporal sklerozlu hastalarda entorinal korteks ve hipokampal volüm ölçümlerinin karşılaştırılması

Abstract

The aim of this study is to evaluate the frequency of EC (Entorhinal cortex) atrophy in patients with TLE (Temporal Lobe Epilepsy) demostrate the diagnostic value in patients with or without hippocampal sclerosis.

Metod: 23 patients, with TLE who were observed and recording in the Video-EEG monitorization and a control group of 17 patients were involved in the study. In both goups differences between video recordings of seizures with syncronized EEG recording were evaluated and lateralization of the seizure focus or the relation with the dominant hemisphere were recorded. 3D-T1 secands hippocampus and EC layers were calculated and mean volume were calculated.

Results: The lateralization signs; versiv head deviation, concurrency of ipsilateral automatism with contralateral dystonic posture and the 4 sign were found to lateralize the contralateral of the seizure focus, while speech arrest lateralize the dominant hemisphere. There were no differences in the frequency of lateralization sign between the group of patients with hippocampal sclerosis and the other group without hippocampal screlosis. In both of the patient groups, frequency of EC atrophy was statistically significant. Although reduction of EC volumes were frequently bilateral in both groups, EC volumes were found to be smaller at the ipsilateral seizure focus.

Conclusion: The present study demostrated that most of the patients with TLE had EC atrophy. EC volume measurements with Video-EEG monitoring and neuropsychometric tests can be useful in some circumstanses where it's difficult to distinguish between TLE and Extra Temporal Lobe Epilepsy and especially to distinguish frontal and temporal seizures.